Pubdate: Fri, 24 Dec 2010
Source: Denver Post (CO)
Copyright: 2010 The Denver Post Corp
Contact:  http://www.denverpost.com/
Details: http://www.mapinc.org/media/122
Author: John Ingold
Bookmark: http://www.mapinc.org/find?277 (Cannabis - Medicinal -  Colorado)

COLORADO DOCTOR DEFENDS RECOMMENDING MARIJUANA TO A PREGNANT PATIENT

A Colorado doctor under fire for recommending marijuana to a pregnant 
woman says he provided the patient with appropriate care and disputes 
that pregnancy and medical marijuana don't mix.

Dr. Manuel Aquino, who could lose his medical license over the 
recommendation in January, also says the woman's behavior was 
"intentional, reckless or grossly negligent" in not telling him 
during the exam that she was pregnant. He also accuses the Colorado 
Medical Board of taking too long to bring a case against him and says 
newlaws requiring a fuller relationship between doctors recommending 
marijuana and patients seeking it were not in place when he made the 
recommendation.

"The charges herein do not allege conduct below the standard of 
care," Aquino states in his defense.

Aquino's response comes in a document filed late Wednesday in the 
administrative case against him. In that case, the Colorado Medical 
Board is seeking to strip his license, which would make him the first 
doctor punished for substandard care in making a marijuana recommendation.

The medical board accuses Aquino of writing the recommendation for 
the woman, who was six months pregnant, after a 3-minute visit in 
which he didn't perform a physical exam, didn't review her medical 
history and didn't ask whether she was pregnant.

Aquino, though, says new regulations requiring him to have a 
"bona-fide" relationship with marijuana-seeking patients weren't in 
place in January. He also denied a statement contained in the medical 
board's complaint that "pregnancy is a contraindication for the use 
of medical marijuana."

Aquino's attorney, Sheila Meer, has declined to comment. The case is 
scheduled for a hearing in March.

News of Aquino's prosecution has spurred comments on online cannabis 
message boards debating whether marijuana use during pregnancy is 
harmful. Medical research hasn't been unanimously conclusive on the 
subject, though several studies suggest prenatal marijuana exposure 
can have negative consequences for children.

A 2009 article in the European Archives of Psychiatry and Clinical 
Neuroscience noted that numerous studies have shown marijuana use 
during pregnancy can result in low birth weight and children with 
hyperactivity, and short-term memory and impulse-control problems.

"Recent evidence suggests that perinatal (marijuana) exposure alters 
fundamental developmental processes," the study's authors wrote.

Other studies, such as a 1983 report in the American Journal of 
Public Health, conclude that differences between children of 
marijuana users and non-marijuana users aren't statistically 
significant. Nearly every study says the question needs further research.

Alan Shackelford, a Denver nutritional and behavioral medicine doctor 
who is also a medical-marijuana specialist, said it is important for 
doctors to do thorough exams on patients seeking cannabis. He said 
his exams last up to an hour and include detailed discussions about a 
patient's conditions and prior treatment.

When making a decision, Shackelford said, doctors must weigh the 
benefits of marijuana versus the risks and err on the side of caution.

"It's not different if someone is being evaluated for cannabis," said 
Shackelford, who serves on a state medical-marijuana advisory board. 
"The person is being evaluated for their medical condition."
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MAP posted-by: Jay Bergstrom